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社会支持、共同决策与患者对医生信任的关系:一项基于 2197 例住院患者的横断面调查,采用科隆患者问卷。

The relationship between social support, shared decision-making and patient's trust in doctors: a cross-sectional survey of 2,197 inpatients using the Cologne Patient Questionnaire.

机构信息

Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Eupener Str. 129, Cologne, Germany.

出版信息

Int J Public Health. 2011 Jun;56(3):319-27. doi: 10.1007/s00038-010-0212-x. Epub 2010 Nov 13.

Abstract

OBJECTIVES

Empirical studies have confirmed that a trusting physician-patient interaction promotes patient satisfaction, adherence to treatment and improved health outcomes. The objective of this analysis was to investigate the relationship between social support, shared decision-making and inpatient's trust in physicians in a hospital setting.

METHODS

A written questionnaire was completed by 2,197 patients who were treated in the year 2000 in six hospitals in Germany. Logistic regression was performed with a dichotomized index for patient's trust in physicians.

RESULTS

The logistic regression model identified significant relationships (p < 0.05) in terms of emotional support (standardized effect coefficient [sc], 3.65), informational support (sc, 1.70), shared decision-making (sc, 1.40), age (sc, 1.14), socioeconomic status (sc, 1.15) and gender (sc, 1.15). We found no significant relationship between 'tendency to excuse' and trust. The last regression model accounted for 49.1% of Nagelkerke's R-square.

CONCLUSIONS

Insufficient physician communication skills can lead to extensive negative effects on the trust of patients in their physicians. Thus, it becomes clear that medical support requires not only biomedical, but also psychosocial skills.

摘要

目的

实证研究已经证实,信任的医患互动可以提高患者满意度、治疗依从性和改善健康结果。本分析的目的是调查社会支持、共同决策和住院患者对医生信任之间的关系。

方法

在德国的六家医院中,对 2197 名 2000 年接受治疗的患者进行了书面问卷调查。使用医生信任的二分索引进行逻辑回归分析。

结果

逻辑回归模型确定了具有显著关系(p<0.05)的因素,包括情感支持(标准化效应系数[sc],3.65)、信息支持(sc,1.70)、共同决策(sc,1.40)、年龄(sc,1.14)、社会经济地位(sc,1.15)和性别(sc,1.15)。我们没有发现“原谅倾向”与信任之间存在显著关系。最后一个回归模型解释了 Nagelkerke 的 R 平方的 49.1%。

结论

医生沟通技巧不足会对患者对医生的信任产生广泛的负面影响。因此,很明显,医疗支持不仅需要生物医学技能,还需要社会心理技能。

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